House Democratic leaders huddle on public insurance option

House Democratic leaders faced an impasse late last week as it became clear that a liberal version of the public option did not have enough support in the caucus.

Roll Call reports that the House Democratic leadership huddled Friday to find a way to move forward — particularly on a public option and its inclusion in the House bill — but "ended without a decision. ... Speaker Nancy Pelosi (D-Calif.) had hoped to 'freeze the design' of the package last week, but moderate pushback to her preferred approach to the public plan — one that would reimburse doctors and hospitals at rates pegged to Medicare — forced another delay" (Newmyer and Dennis, 10/26).

Politico reports on how the public option feeds into the struggle to get congressional proposals to meet the President's price tag target. "Costs and the political calendar are catching up with health care reform.
Having bet the farm, President Barack Obama needs a win and is willing to settle for a cheaper bill and a weaker public insurance option. Democrats in Congress, increasingly worried about the 2010 elections, want stronger medicine for fear the reforms will prove to be a house of cards if working-class voters can't afford the coverage promised." In the House, Speaker Nancy Pelosi, D-Calif., "needs the strongest possible public option for the cost control savings it promises," while Senators face pressures of their own (Rogers, 10/26).

Meanwhile, The Hill reports that urban and rural House Democrats are fighting over the Medicare deal announcement in the House: "A group of Democrats announced the Medicare reimbursement rate agreement Thursday after months of negotiations with Democrats from large cities. Lawmakers from rural areas have long believed the Medicare formula shortchanges their local doctors and hospitals in favor of urban centers" (Allen, 10/24).